Efficacy of stem cell-based therapies for colistin-induced nephrotoxicity

The increase in infections with multidrug resistant bacteria has forced to return to the use of colistin, antibiotic with known nephrotoxicity. Mesenchymal stem cells (MSCs) are being extensively investigated for their potential in regenerative medicine. This study aimed to investigate the possible protective mechanisms of the MSCs against kidney injury induced by colistin. Forty adult female albino rats were randomly classified into 4 equal groups; the control group, the MSC-treated group (a single dose of 1 ×10⁶ /ml MSCs through the tail vein), the colistin-treated group (36 mg/kg/day colistin was given for 7 days), and the both colistin and MSC group (36 mg/kg/day colistin and 1 ×10⁶ /ml MSCs). Main outcome measures were histopathological alterations, kidney malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT) and immunohistological autophagy evaluation. MSC repressed the progression of colistin-induced kidney injury as evidenced by the improvement of histopathological alterations and the substantial increase MDA, and decrease SOD and CAT in serum levels. Moreover, MSC resulted in a profound reduction in oxidative stress as manifested by decreased MDA and increased SOD in serum. Notably, MSC suppressed colistin-induced autophagy; it reduced renal levels of Beclin-1, P62 and LC3A/B. Furthermore, MSC decreased renal levels of eNOS. Lastly, MSC efficiently decreased expression of the TUNEL positive cell number. MSC confers protection against colistin-induced kidney injury by alleviating oxidative stress, nitric oxide synthase besides modulating reducing autophagy and apoptosis.     

Application of 3D imaging and selfies in forensic dental identification

With increased access to smartphones, the selfie has gained immense popularity in the past decade. Selfie images could be a significant source of ante-mortem (AM) image data in cases where dental records are unavailable or considered insufficient. The application of 3D imaging and selfies has not been explored to its full potential in human dental identification. The present study aimed to evaluate the feasibility of using selfies as AM data and comparing with 3D post-mortem (PM) scans as an alternative to multiple 2D PM photographs in forensic dental identification. The study sample consisted of 18 selfies (12 matching and 6 non-matching) and 15 3D dental scans obtained from the study participants. The study sample was assessed by 6 experienced forensic odontologists (Raters) in two phases; Phase I-Visual comparison of 2D selfies to 3D scans and Phase II-2D selfies superimposed upon 3D scans. Each rater looked at 15 cases, and a total of 1620 comparisons were made by 6 raters (72 for the 12 matching cases and 1548 were for non-matching) and the opinions for each of the comparisons were analyzed. The results of the study show that use of the 3D superimposition method increased the certainty of the conclusions reached by the raters for the cases with correct matches. Furthermore, 94.2% of the 1548 non-matching comparisons were correctly excluded, compared with 77% for the 2D visual comparison method. The study demonstrated the applicability of this 3D method as a valuable tool in assisting the forensic odontologist with dental identification using selfies.     

基于奥马哈理论的围手术期全程康复管理对TAVR患者心理应激、6 min步行距离及并发症的影响

目的 探讨基于奥马哈理论的围手术期全程康复管理对经导管主动脉瓣置换术（transcatheter aortic valve replacement，TAVR）患者心理应激、6 min步行距离及并发症的影响。 方法 选取我院74例TAVR患者，采用随机数字表法分为2组，各37例。对照组采取传统围术期护理，在对照组基础上，观察组采取基于奥马哈理论的围手术期全程康复管理。统计2组并发症、护理满意度及护理前后心理应激、心功能指标、健康行为（health promotionlifestyleprofile-Ⅱ，HPLP-Ⅱ）、6 min步行距离及生活质量。 结果 观察组干预后左心室舒张末期内径、跨瓣压差较对照组低，主动脉瓣面积、左心室射血分数高于对照组（P＜0.05）；观察组干预后特质焦虑（Trait Anxiety Inventory，T~AI）、状态焦虑（State Anxiety Inventory，S~AI）评分低于对照组（P＜0.05）；观察组干预后HPLP-Ⅱ量表6个维度评分高于对照组（P＜0.05）；观察组术后3个月、6个月生活质量及6 min步行距离高于对照组（P＜0.05）；2组并发症比较差异无统计学意义（P＞0.05）。 结论 基于奥马哈理论的围手术期全程康复管理应用于TAVR患者，可减轻其心理应激，提高患者健康促进生活方式水平，预防并发症发生，在改善患者心功能、运动耐力和提高患者护理满意度方面具有积极意义。     

糖尿病视网膜病变的流行病学、病因学与发病机制研究现状北大核心

糖尿病视网膜病变(DR)是全球工作年龄人群视力丧失的主要原因,根据国际糖尿病地图研究预测,2045年中国糖尿病患者将达1.74亿,DR正在成为全球公共卫生问题。本文就DR的流行病学、病因学、发病机制作一阐述,从DR的流行病学推测疾病将来会波及的人群数量,提醒我们要高度重视本病的预防。从糖尿病的病程发展推测可能的病因学,从氧化应激等反应来研究DR的发病机制,以便开发可靠和有力的手段识别高风险患者,并在视力丧失发生之前进行有效干预。     

B7-H4及Fas、FasL与宫颈癌免疫逃逸机制的关系

目的:检测免疫共刺激分子B7-H4及Fas、FasL在不同宫颈组织中的表达，研究三者的异常表达与宫颈癌免疫逃逸机制的关系。方法:选择陕西省肿瘤医院病理科2014-2018年的石蜡包埋标本162例，采用免疫组织化学方法检测20例正常宫颈、30例宫颈上皮内瘤变(CIN)和112例I期-IV期宫颈癌组织中B7-H4及Fas、FasL的表达水平。结果:B7-H4在正常宫颈组、CIN组、宫颈癌组的阳性表达率分别为0、20.0%、47.32%，两两相比，具有显著性差异（P<0.05）。在112例宫颈癌病例中FIGO临床分期I期至IV期各期别宫颈癌组织B7-H4的阳表达率分别为16.67%、43.18%、70.83%、85.71%，各组间相比差异具有统计学意义。正常对照组Fas的阳性表达率是85.00％，CIN组43.33％，宫颈癌组41.96％，正常组与CIN、正常组与宫颈癌组相比差异均具有统计学意义（P<0.05），CIN组与宫颈癌组相比，无明显差异（P>0.05）。FasL的阳性表达率在正常组为20.00%，CIN组为50.00%，宫颈癌组为56.25%，正常组与CIN、宫颈癌组比较，差异具有统计学意义(P<0.05)，CIN组与宫颈癌组比较无显著差异;B7-H4阳性宫颈癌组Fas阳性表达率28.30%明显较B7-H4阴性宫颈癌组Fas阳性表达率54.24%低，差异具有统计学意义（P<0.05）；而B7-H4阳性宫颈癌组FasL阳性表达率79.25%明显高于B7-H4阴性宫颈癌组FasL阳性表达率35.59%，差异具有统计学意义（P<0.05）。结论:负性免疫共刺激分子B7-H4和Fas、FasL凋亡蛋白在宫颈癌的发生、进展中起到了重要作用，其协同作用可能为宫颈癌细胞逃逸机体免疫的机制之一。     

Comparison of survival between adolescent and young adult vs older patients with hepatocellular carcinoma

BACKGROUNDDue to the special clinical features and biologic characteristics of adolescent and young adult (AYA) cancers, AYA cancers are different from cancers in children and elderly individuals. However, there are few reports on AYA hepatocellular carcinoma (HCC).AIMTo investigate the overall survival (OS) of AYA (15-39 years) and elderly (40-74 years) patients with HCC.METHODSThe data of all the HCC cases were extracted from the Surveillance, Epidemiology, and End Results database from 2004 to 2015 and were then divided into two groups based on age: AYA group (15-39 years) and older group (40-74 years). Kaplan-Meier curves and log-rank tests were used to compare the OS of the two groups. Propensity score matching (PSM) was employed to analyze the OS difference between the two groups. The Cox proportional hazards regression model was used to perform multivariate analysis to explore the risk factors for OS of HCC patients.RESULTSCompared to elderly cancer patients, AYA patients with HCC had a worse Surveillance, Epidemiology, and End Results stage, including the distant stage (22.1% vs 15.4%, P < 0.001), and a more advanced American Joint Committee on Cancer (AJCC) stage, including AJCC III and IV (49.2% vs 38.3%, P < 0.001), and were more likely to receive surgery (64.5% vs 47.5%, P < 0.001). Before PSM, the AYA group had a longer survival in months (median: 20.00, interquartile range [IQR]: 5.00-62.50) than the older group (median: 15.00, IQR: 4.00-40.00) (P < 0.001). After PSM, the AYA group still had a longer survival in months (median: 21.00, IQR: 5.00-64.50) than the older group (median: 18.00, IQR: 6.00-53.00) (P < 0.001). The Cox proportional hazards regression model showed that advanced age (hazard ratio [HR] = 1.405, 95%CI: 1.218-1.621, P < 0.001) was a risk factor for OS of HCC patients. In the subgroup analysis, the Cox proportional hazards regression model showed that in AJCC I/II HCC patients, advanced age (HR = 1.749, 95%CI: 1.352-2.263, P < 0.001) was a risk factor for OS, while it was not a risk factor in AJCC III/IV HCC patients (HR = 1.186, 95%CI: 0.997-1.410, P = 0.054) before PSM. After PSM, advanced age (HR = 1.891, 95%CI: 1.356-2.637, P < 0.001) was still a risk factor for OS in AJCC I/II HCC patients, but was not a risk factor for OS in AJCC III/IV HCC patients (HR = 1.192, 95%CI: 0.934-1.521, P = 0.157) after PSM.CONCLUSIONAYA patients with HCC have different clinical characteristics from older adults. In different AJCC stages, the two groups of patients have different OS: In AJCC I/II HCC patients, advanced age is a risk factor for OS, but it is not a risk factor for OS in the AJCC III/IV HCC patient group.     

The potential markers of endocrine resistance among HR+ /HER2+ breast cancer patients

Clinical and Translational Oncology - Breast cancer with positive hormone receptor (HR) and human epidermal growth factor receptor-2 (HER2) is a special subgroup with different clinical features...     

张卫华教授独特进针行针手法

张卫华教授在传承传统进针和行针手法的基础上,根据人体解剖位置、患病部位特征确定相应的进针手法,头部穴位应用飞针走气、颈腰部夹脊穴应用雀啄提插进针法;行针方面创立了滞针外甩、左右扇形摆动、顺逆时针环转、上抬下压,不仅局部针感明显,临床疗效更佳,值得推广应用。     

风三针治疗中风后吞咽障碍临床研究

目的:观察“风三针”针刺疗法在治疗中风后吞咽障碍的临床疗效。方法:随机收集中风后吞咽障碍患者60例,按照不同的治疗方法分为对照组和治疗组各30例。两组均先进行吞咽康复训练,后治疗组予风三针针刺治疗,观察两组治疗后洼田饮水试验评分,VFSS吞咽难度评分,并进行对比分析其临床疗效。结果:对照组及治疗组在治疗4个疗程后,治疗组总有效率93.33%高于对照组70.00%(P<0.05); 两组洼田饮水试验评分治疗后均低于治疗前(P<0.05),治疗组的评分低于对照组(P<0.05); 两组的VFSS吞咽难度评分治疗后均高于治疗前(P<0.05); 治疗组的VFSS难度评分高于对照组(P<0.05)。结论:“风三针”针刺疗法在治疗中风吞咽障碍中临床疗效确切。